Mortality Changes Associated with Mandated Public Reporting for Sepsis. The Results of the New York State Initiative
| Autor: | Marcus Friedrich, Kathleen M. Terry, Christopher W. Seymour, Theodore J. Iwashyna, Foster C. Gesten, Stanley Lemeshow, Mitchell M. Levy, Tiffany M. Osborn, Gary Phillips, Hallie C. Prescott |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty New York Critical Care and Intensive Care Medicine Cohort Studies Sepsis 03 medical and health sciences 0302 clinical medicine Public reporting medicine Humans Hospital Mortality 030212 general & internal medicine Intensive care medicine Severe sepsis Aged Implementation Science Aged 80 and over business.industry Health Policy Editorials Reproducibility of Results Original Articles Length of Stay Mandatory Reporting Middle Aged medicine.disease humanities 030228 respiratory system Female Guideline Adherence business |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 198:1406-1412 |
| ISSN: | 1535-4970 1073-449X |
| Popis: | Rationale: In 2013, the New York State Department of Health (NYSDOH) began a mandatory state-wide initiative to improve early recognition and treatment of severe sepsis and septic shock. Objectives: This study examines protocol initiation, 3-hour and 6-hour sepsis bundle completion, and risk-adjusted hospital mortality among adult patients with severe sepsis and septic shock. Methods: Cohort analysis included all patients from all 185 hospitals in New York State reported to the NYSDOH from April 1, 2014, to June 30, 2016. A total of 113,380 cases were submitted to NYSDOH, of which 91,357 hospitalizations from 183 hospitals met study inclusion criteria. NYSDOH required all hospitals to submit and follow evidence-informed protocols (including elements of 3-h and 6-h sepsis bundles: lactate measurement, early blood cultures and antibiotic administration, fluids, and vasopressors) for early identification and treatment of severe sepsis or septic shock. Measurements and Main Results: Compliance with elements of the sepsis bundles and risk-adjusted mortality were studied. Of 91,357 patients, 74,293 (81.3%) had the sepsis protocol initiated. Among these individuals, 3-hour bundle compliance increased from 53.4% to 64.7% during the study period (P |
| Databáze: | OpenAIRE |
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